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Liver transplant programs in Canada require a period of 6 months of abstinence from alcohol before considering a patient with liver disease secondary to alcohol for transplantation. Although some studies have demonstrated good outcomes following a transplant in carefully selected patients before the 6‐month abstinence period has been met, there have been arguments against this, including the claim that the public has a general negative perception of those with alcohol dependence. We performed a multicenter cross‐sectional survey to determine the perception of people in British Columbia, Canada, toward liver transplantation in patients with liver disease due to alcohol who have not demonstrated the capacity to remain abstinent from alcohol for 6 months. A total of 304 patient questionnaires were completed, and 83.1% agreed with a period of abstinence of 6 months. In those patients who were unlikely to survive 6 months without a transplant, 34.1% of respondents agreed with, 44.1% did not agree with, and 21.4% were neutral about, early transplantation; 42.8% would have less trust in the process of transplantation if a period of abstinence was not maintained, but relaxing the requirement for an abstinence period would not have an impact on the majority's decision to donate organs. Only 30.5% would support abandoning the abstinence criteria. Conclusion: Among patients followed at general gastroenterology, medicine, or transplant clinics, there is a willingness to relax the criteria in selected patients unlikely to survive without a transplant, although a general consensus remains in support of the existing 6‐month alcohol abstinence rule. A larger scale survey of all provinces in Canada would be required to assess support for such a change in policy.

Introduction The paper describes and examines a novel methodology to co-define transport and mobility challenges and co-create solutions with residents of a socioeconomically disadvantaged area within Oxford in the UK. The co-creation methodology is examined in relation to the extent of participation, inclusivity, transparency, interactivity, scale, sustainability/continuity, replicability, potential for co-benefits. Methods A Citizen Mobility Community was established with local residents at the core, and including representatives from the local authority, and other stakeholders. The paper describes the main elements of the co-creation process applied to identify mobility challenges, identify solutions, endorse the mobility solutions, and develop the solutions into practical action. Setting The setting was the Eastern Arc of Oxford, the most socioeconomically deprived area in Oxford. Results A sequence of co-creation activities helped identify and understand the transport challenges in Barton in the Eastern Arc of Oxford. Challenges included the high cost of public transport, traffic congestion, particularly during morning peak times, and the lack of cross-connectivity and direct public transport routes to desirable locations including affordable supermarkets, train stations, workplaces, health services such as hospitals and other neighbourhoods. The co-creation methodology led to the development of three pilot interventions to address these challenges, namely face-to-face transport app training, a transport to supermarkets shuttle service, and an information campaign about concessionary bus passes. Analysis of the co-creation methodology found that the process achieved its aims of empowering citizens in decision making about addressing locally experienced transport challenges, and building social capital. Conclusions The co-creation enables communities in areas of socioeconomic disadvantage to identify their transport challenges, and to co-develop and co-design practical solutions. Co-creation to address local transport needs builds community empowerment, creates social capital and may contribute, through plausible causal pathways, to improved health and wellbeing in an area of socioeconomic disadvantage.

The pattern of intragastric Helicobacter pylori colonization and its density may be determined by parietal cell function. H. pylori bacterial products can inhibit gastric acid secretion from the parietal cell. The aim of this investigation was to study the relationship between acid output and intragastric H. pylori distribution and colonization density in duodenal ulcer (DU) and non-ulcer subjects. The study included 14 patients with active DU, 10 with inactive DU and 10 non-ulcer dyspeptics.Acid output studies in response to fasting and maximal pentagastrin stimulation, basal (BAO) and peak (PAO) acid outputs were calculated. A quantitative assessment of H. pylori colonization density in biopsies from five sites of the gastroduodenum in the active ulcer group, and from the antrum in inactive duodenal ulcer and non-ulcer groups.There were negative correlations between total gastroduodenal bacterial colonization density and, PAO (r - 0.87, p = 0.0025) and BAO (r - 0.635, p0.02) in the active ulcer group. There were negative correlations between antral H. pylori colonization density and PAO in the active duodenal ulcer (r - 0.7449, p0.01) and non-ulcer (r - 0.5837, p0.1) groups but not in the inactive duodenal ulcer group (r - 0.1869, p0.2).An equilibrium is reached between gastroduodenal H. pylori colonization density and gastric acid secretory capacity in active duodenal ulcer disease. It is hypothesized that thresholds of bacterial load and acid secretory capacity, in combination, are required for active ulceration in DU disease.